Is Higher Acceptance Associated With Less Anticipatory Grief Among Patients in Palliative Care?

Davis, Ed; Deane, Frank P.; Lyons, Geoffrey; Barclay, Gregory D.

doi:10.1016/j.jpainsymman.2017.03.012

Cited by 28 publications

(30 citation statements)

References 34 publications

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“…The Patient Health Engagement model not only describes the patient’s emotional adjustment to the disease and diagnosis, but also tries to describe how the self-concept is reconfigured [12]. Acceptance-based interventions, from approaches such as Acceptance and Commitment Therapy, are also being applied to patients in palliative care [13]. However, terminally ill patients do not always accept death, and many require mental healthcare in order to manage the negative emotions generated by the awareness of their imminent mortality.…”

Section: Introductionmentioning

confidence: 99%

How to come to terms with facing death: a qualitative study examining the experiences of patients with terminal Cancer

Kyota

Kanda

2019

BMC Palliat Care

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Background Cancer patients who have reached the terminal stage despite attempts at treatment are likely to experience various problems, particularly as they encounter increasing difficulty in doing what they were able to do easily, and their physical symptoms increase as the disease advances. The purpose of this study is to explore how terminal cancer patients who have not clearly expressed a depressed mood or intense grief manage their feelings associated with anxiety and depression. Methods Eleven terminally ill patients with cancer who were receiving symptom-relieving treatment at home or in palliative care units were interviewed. Interviews were generally conducted weekly, two to five times for each participant. In total, 33 interviews were conducted, and the overall interview time was 2027 min. Data were analyzed via qualitative methods. Results The following five themes were extracted regarding the experience of managing feelings associated with anxiety and depression when facing death: “I have to accept that I have developed cancer,” “I have to accept the undeniable approach of my own death,” “I have to accept my need for assistance,” “I have to accept this unsatisfactory circumstance” and “I have to accept this as my destiny and an outcome of my life.” Conclusion The present study revealed key themes related to how patients come to terms with their impending death. Nurses are required to comprehend the patients’ complicated mental patterns that are expressed in their daily languages. Furthermore, the findings clarify the necessity for nurses to help patients understand the acceptance of a terminal disease state during a patient’s final days.

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Section: Introductionmentioning

confidence: 99%

How to come to terms with facing death: a qualitative study examining the experiences of patients with terminal Cancer

Kyota

Kanda

2019

BMC Palliat Care

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“…Previous studies have shown that preparedness and acceptance of death are important attributes of a peaceful death and healthy grieving. 5–9 The present study shows that MBSR offered to lung cancer patients and their partners can facilitate the regulation of thoughts and emotions, fostering acceptance of the forthcoming death and an open communication between partners about the imminent farewell. In turn, this seemed to result in a peaceful death and healthy grieving.…”

Section: Discussionmentioning

confidence: 61%

Perspectives of bereaved partners of lung cancer patients on the role of mindfulness in dying and grieving: A qualitative study

et al. 2020

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Background: Mindfulness-Based Stress Reduction (MBSR) has been shown to reduce psychological distress in cancer patients but not their partners. Whether MBSR can support patients and partners in coping with the dying and grieving process is less well examined. Aim: We aimed to gain more insight in the role of mindfulness in the dying and grieving process from the perspective of the partner after the patient’s death. Design: As part of a pilot study or subsequent randomized controlled trial, partners had participated together with the patient in MBSR. After the patient’s death partners were invited for qualitative in-depth interviews. Data from the interviews was analyzed using the grounded theory approach. Setting/participants: Interviews were conducted with 11 partners in their homes, on average 11 months after the patient’s death (SD = 7.8). Results: Mindfulness helped couples to allow and regulate difficult thoughts and feelings, which in turn helped them to accept the patient’s impending death. It also facilitated them to enjoy things together and communicate more openly. For a few couples, however, participation was physically too burdensome or emotionally too confrontational. During the partners’ grieving process, mindfulness helped allowing difficult thoughts and feelings, and taking the time to grieve, which helped them to take good care of themselves, giving them faith in the future. Conclusion: The present study showed that MBSR can facilitate lung cancer patients and their partners in accepting the forthcoming death and openly communicating about this, which can support a peaceful death and healthy grieving process.

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“…Several factors highlight the importance of dealing with anticipatory grief in nursing homes: ambivalence between caregivers’ desire to take a break from caring for the patient, the desire to avoid their death, and emotional dependence on the patient can lead to subsequent grief complications [ 55 ]. Acceptance of death by both parties can help prioritize decision-making, prioritize patient comfort over longevity, and help family members deal with the subsequent loss [ 56 , 57 ]. Improved family communication can also make it easier to say goodbye to loved ones [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

NUrsing Homes End of Life care Program (NUHELP): developing a complex intervention

et al. 2021

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Background Nursing homes are likely to become increasingly important as end-of-life care facilities. Previous studies indicate that individuals residing in these facilities have a high prevalence of end-of-life symptoms and a significant need for palliative care. The aim of this study was to develop an end-of-life care program for nursing homes in Spain based on previous models yet adapted to the specific context and the needs of staff in nursing homes in the country. Methods A descriptive study of a complex intervention procedure was developed. The study consisted of three phases. The first phase was a prospective study assessing self-efficacy in palliative care (using the SEPC scale) and attitudes towards end-of-life care (using the FATCOD-B scale) among nursing home staff before and after the completion of a basic palliative care training program. In the second phase, objectives were selected using the Delphi consensus technique, where nursing home and primary care professionals assessed the relevance, feasibility, and level of attainment of 42 quality standards. In phase 3, interventions were selected for these objectives through two focus group sessions involving nursing home, primary care, and palliative care professionals. Results As a result of the training, an improvement in self-efficacy and attitudes towards end-of-life care was observed. In phase 2, 14 standards were selected and grouped into 5 objectives: to conduct a comprehensive assessment and develop a personalized care plan adapted to the palliative needs detected; to provide information in a clear and accessible way; to request and record advance care directives; to provide early care with respect to loss and grief; to refer patients to a specialized palliative care unit if appropriate, depending on the complexity of the palliative care required. Based on these objectives, the participants in the focus group sessions designed the 22 interventions that make up the program. Conclusions The objectives and interventions of the NUHELP program constitute an end-of-life care program which can be implemented in nursing homes to improve the quality of end-of-life care in these facilities by modifying their clinical practice, organization, and relationship with the health system as well as serving as an example of an effective health intervention program.

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Is Higher Acceptance Associated With Less Anticipatory Grief Among Patients in Palliative Care?

Abstract: The present study provides preliminary data suggesting that interventions that target acceptance may be indicated in patients in palliative care.

Cited by 28 publications

References 34 publications

How to come to terms with facing death: a qualitative study examining the experiences of patients with terminal Cancer

How to come to terms with facing death: a qualitative study examining the experiences of patients with terminal Cancer

Perspectives of bereaved partners of lung cancer patients on the role of mindfulness in dying and grieving: A qualitative study

NUrsing Homes End of Life care Program (NUHELP): developing a complex intervention

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